Health, care and emergency service workers are working in extraordinary times and under exceptional pressures. This is, understandably, putting significant strain on our personal resilience. We appreciate that you are incredibly busy, but please take the time to allow us to help you by completing this referral form. We appreciate that this will not tell us the full story, but it provides a great starting point for us to understand how you are feeling and allow us, as a team, to create dedicated support for you.

It takes an average of 15 minutes to complete the form, but you may wish to allow yourself more time if you find it difficult to think about your emotions at the moment.

If you feel unhappy about completing the form, or if you want support to complete it with one of our team, please contact us directly on hny.resiliencehub@nhs.net or call 03300 022 044.

You can also find out more about the form at Wellbeing Questionnaire.

Please note this form is completely and strictly confidential and will only be seen by the Resilience Hub Team. None of the personal information gathered within the Resilience Hub will be used or passed on to your place of work in any way. The information collected is also anonymised for data collection and research purposes and is important in us being able to establish the demand for these crucial confidential staff support services. Once you’ve completed the form you’ll receive an email acknowledgement - we will be in touch as soon as possible via email or telephone (pending your consent) to confirm the next steps for your support.

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